ACCESS DENTAL SERVICES LP
NPI: 1376088369
· MOUNTAIN GROVE, MO 65711
· General Practice Dentistry
· NPI assigned 12/29/2016
$116K
Total Medicaid Paid
Provider Details
| Authorized Official | HICKS, KARI (SR ADMINISTRATOR) |
| NPI Enumeration Date | 12/29/2016 |
Related Entities
Other providers sharing the same authorized official: HICKS, KARI
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
1,092 |
$40K |
| 2019 |
579 |
$12K |
| 2020 |
94 |
$2K |
| 2021 |
56 |
$1K |
| 2022 |
370 |
$19K |
| 2023 |
340 |
$25K |
| 2024 |
278 |
$17K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0330 |
Panoramic radiographic image |
687 |
649 |
$41K |
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
293 |
82 |
$24K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
368 |
352 |
$18K |
| D7140 |
Extraction, erupted tooth or exposed root |
327 |
68 |
$14K |
| D0140 |
Limited oral evaluation - problem focused |
285 |
243 |
$8K |
| D0220 |
Intraoral - periapical first radiographic image |
563 |
512 |
$7K |
| D0274 |
Bitewings - four radiographic images |
90 |
88 |
$2K |
| D0230 |
Intraoral - periapical each additional radiographic image |
168 |
84 |
$1K |
| D1110 |
Prophylaxis - adult |
28 |
28 |
$760.42 |